A typical day in Uganda, a landlocked country in East-Central Africa, consists of children playing along the shores of the lake while adults fish in wooden boats. On
the same day, among mud huts, women clean their laundry in the lake and cows walk alongside villagers as they fetch their drinking water. From a quick glance, it is hard to realize that just feet from the water human feces is scattered along the shore and many of the playing children have bloated bellies due to infection. This is because Ugandan communities such as these have become the perfect place for a waterborne disease, known as schistosomiasis, to thrive.
In many countries like Uganda, parasitic diseases including schistosomiasis have become a public health crisis. Schistosomiasis is primarily caused by parasitic worms called cercariae. Cercariae get released into freshwater after infecting snails and contaminate water sources. This makes the risk of getting schistosomiasis very high in countries where people bathe and drink directly from water sources that contain snails, which is often the case in many African countries like Uganda. When humans bathe or drink from a contaminated water source, cercariae infect their bodies whenever given the chance. Once cercariae enter the body they typically migrate into the vessels of the bladder and bowel, where they mate and lay eggs. The eggs then either remain in the person infected or are excreted through their feces or urine. By leaving the human body, these eggs can infect more snails leading to more contaminated water sources and more people infected. This continuous cycle has caused schistosomiasis to run rampant in Uganda.
When a Ugandan is infected with schistosomiasis they are typically infected for 3 to 10 years if no intervention is taken, making schistosomiasis a chronic disease. Some symptoms of schistosomiasis are abdominal pain, diarrhea, bloody stool, enlarged liver, and bloody urine. Over time, schistosomiasis can cause tissue damage, malnutrition, bladder cancer, and a number of other genital problems. These symptoms take a greater toll on kids who can also have stunted growth, anemia, and impaired ability to learn. Children and adults may also get increasingly bloated stomachs the longer they are infected with schistosomiasis showing how physically tolling schistosomiasis can eventually become. All of these factors contribute to why the World Health Organization (WHO) has placed schistosomiasis on its priority list and ranked the disease only second to malaria in terms of human suffering in tropical and subtropical regions. These factors also explain the WHO’s classification of schistosomiasis as a disease of poverty since impoverished conditions are the perfect breeding ground for infection. In the face of all this information, one common question remains: how can we stop this?
Fighting schistosomiasis in Uganda presents some unique challenges with more than 4 million Ugandan citizens estimated to be infected with schistosomiasis every year and the prevalence of schistosomiasis being near 80% around lakeshores. According to Uganda Demographic and Health Surveys, 21.4% of Ugandans live on less than $1 a day making a large swath of the Ugandan population severely impoverished and increasing their risk for schistosomiasis infection. Further complicating things, schistosomiasis also does not just exist in rural Uganda but in urban areas of Uganda as well with 65% of Kampala residents, those who live in Uganda’s capital city, being infected. Globally, at least 230 million people have been infected with schistosomiasis and annually about 200,000 die from the parasite. All of these factors have only intensified the need for governmental and non-governmental organizations (NGOs) to step up in helping to fight against schistosomiasis in areas where the disease has spread untamed.
Fortunately, schistosomiasis is not only preventable but entirely treatable. In fact, one of the most effective methods of fighting schistosomiasis is by administering anti-parasitic drugs like praziquantel or albendazole, which when taken by someone infected can completely cure them of schistosomiasis. Along with schistosomiasis prevention education, distribution of vitamin A for malnutrition, and data gathering, health workers can use anti-parasitic drugs to once and for all eliminate schistosomiasis in a number of communities.
Unfortunately, resources in Uganda lag behind treatment efforts and many health agencies in Uganda have issues recruiting, deploying, and maintaining healthcare workers. Uganda also faces an uphill battle in preventing the spread of schistosomiasis with most of the country lacking toilets and modern sewage systems. Luckily, NGOs have made several strides towards not only administering schistosomiasis treatments but also working with communities to prevent citizens from being infected with schistosomiasis. One such agency is Empower Through Health (ETH) and one of its branches Empower Through Health Youth St. Louis. Donations to Empower Though Health Youth St. Louis directly fund health care workers and treatment centers in Uganda and by donating you can help to make schistosomiasis history!
The photos above show ETH-funded health workers in Uganda treating children and educating the community on how to prevent schistosomiasis. Photos courtesy of Ugandan health workers on-site.